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Ellis É, Wieling E, Tate A. Complex Posttraumatic Stress Disorder Links Trauma Exposure and Suicidal Behaviors Among Sexual Minority Populations: A New Target in Suicide Prevention? JOURNAL OF HOMOSEXUALITY 2024; 71:2300-2318. [PMID: 37466931 DOI: 10.1080/00918369.2023.2233654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Exposure to potentially traumatic events and posttraumatic stress are known risk factors for suicidal thoughts and behaviors (STB). Research suggests that sexual minorities are disproportionately exposed to traumatic events and experience greater STB than their heterosexual peers, although few studies have explored connections between these parallel disparities. Further, existing literature may implicate complex posttraumatic stress disorder (CPTSD) as a potential mechanism in the trauma-suicide connection among sexual minorities. This study uses a sample from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; n = 1351) to test structural equation models for associations between trauma exposure, heterosexist discrimination, and CPTSD with suicide attempt status. We found CPTSD mediated associations between exposure to traumatic events and presence of a lifetime suicide attempt among sexual minority male and female samples. Discrimination demonstrated a synergistic effect on the association between trauma exposure and CPTSD, but, among males, CPTSD did not fully explain associations between discrimination and suicide attempts. Our findings suggest that CPTSD should be considered an important mechanism in the trauma-suicide connection for sexual minorities and may be a potentially important target for suicide prevention and that interventions should address the influence of discrimination on traumatic stress in this high-risk population.
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Affiliation(s)
- Émilie Ellis
- College of Public Health, University of Georgia School of Public Health, Athens, Georgia, USA
| | - Elizabeth Wieling
- Human Development and Family Science, University of Georgia Department of Human Development and Family Science, Athens, Georgia, USA
| | - Allan Tate
- College of Public Health, University of Georgia School of Public Health, Athens, Georgia, USA
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Wallace ER, O'Neill S, Lagdon S. Risk and protective factors for suicidality among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people, from countries with a high global acceptance index (GAI), within the context of the socio-ecological model: A scoping review. J Adolesc 2024; 96:897-924. [PMID: 38372179 DOI: 10.1002/jad.12308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people experience higher prevalence rates of suicidality than their heterosexual and/or cisgender peers. However, there is limited research that can inform suicide prevention efforts. Our aim was to synthesize quantitative, qualitative, and mixed methods research on risk and protective factors among LGBTQ+ young people, from countries with a high Global Acceptance Index. METHODS A scoping review guided by Arksey and O'Malley's five-stage framework, using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews protocol. Five databases and grey literature were searched for relevant studies. Identified factors were clustered by thematic type, according to the socio-ecological model to identify empirical trends and knowledge gaps. The mixed methods appraisal tool was used for quality assessment of studies. RESULTS Sixty-six studies met our inclusion criteria. Overall, 59 unique risk factors and 37 unique protective factors were identified. Key risk factors include past suicidality, adverse childhood experiences, internalized queerphobia, minority stress, interpersonal violence, bullying, familial conflict, and anti-LGBTQ+ policies/legislation. Key protective factors include self-affirming strategies, adult/peer support, at-school safety, access to inclusive healthcare, family connectedness, positive coming out experiences, gender-affirming services and LGBTQ+ inclusive policies and legislation. CONCLUSIONS Overall, our findings affirm that multiple risk and protective factors, at all levels of the socio-ecological model, interact in complex, unique and diverse ways upon suicidality among LGBTQ+ young people. Implications for suicide prevention are discussed. Further empirical studies are required, particularly at the communities, policies, and societal levels of the socio-ecological model, and these studies should include a focus on protective factors and significant within-group differences.
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Affiliation(s)
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Susan Lagdon
- School of Psychology, Ulster University, Coleraine, Northern Ireland
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Boertien D, Perales F, Pessin L. Does intergenerational educational mobility vary by sexual identity? A comparative analysis of five OECD countries. EUROPEAN SOCIOLOGICAL REVIEW 2024; 40:226-241. [PMID: 38567380 PMCID: PMC10984377 DOI: 10.1093/esr/jcad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/11/2023] [Accepted: 09/14/2023] [Indexed: 04/04/2024]
Abstract
Lesbian, gay and bisexual people are disadvantaged in terms of health and socio-economic status compared with heterosexual people, yet findings pertaining to educational outcomes vary depending on the specific identity and gender considered. This study delves into these unexplained findings by applying a social-stratification lens, thereby providing an account of how intergenerational educational mobility varies by sexual identity. To accomplish this, we use representative data from five OECD countries and a regression-based empirical specification relying on coarsened exact matching. We find that gay and lesbian people have higher educational attainment than heterosexual people in all five countries and that these higher levels of education stem from greater rates of upward educational mobility among gay/lesbian people. There were, however, few differences between heterosexual and bisexual people. Variation across countries emerged when analyses were stratified by gender, with higher rates of upward mobility observed for gay men in Australia, Chile, the United Kingdom, and the United States and lesbian women in Australia and Germany. Overall, our results align with previous claims that education can be a strategy for gay/lesbian people to avoid actual or anticipated discrimination. However, variation in these patterns across groups suggests that other mechanisms may also be at play.
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Affiliation(s)
- Diederik Boertien
- Centre d’Estudis Demogràfics (CED-CERCA), Bellaterra, Barcelona, Spain
| | - Francisco Perales
- School of Social Science, The University of Queensland, Brisbane, QLD, Australia
| | - Léa Pessin
- Center for Research in Economics and Statistics (CREST), GENES, ENSAE Paris, Institut Polytechnique de Paris, Palaiseau, France
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Ching THW, Finkelstein-Fox L, Lee SY, Watson RJ. Effects of sexual and gender minority stress on depressive symptoms among adolescents of color in the United States. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024; 30:309-318. [PMID: 36048116 PMCID: PMC9975117 DOI: 10.1037/cdp0000562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE There is a need for more research on minority stress theory (MST) with sexual and gender minority (SGM) adolescents of color, because of their disproportionate risk for depression. METHOD We recruited 1,627 SGM adolescents of color in the United States to complete measures assessing lesbian, gay, bisexual, transgender, and queer (LGBTQ) climate, LGBTQ microaggressions within one's ethnoracial community, internalized LGBTQ stigma, stress management ability, and depressive symptoms. Using structural equation modeling, a hybrid measurement-structural model was tested, indicating good model fit. RESULTS Multiple significant indirect pathways linking LGBTQ climate and depressive symptoms emerged. A less positive LGBTQ climate was associated with more microaggression-related stress, more internalized LGBTQ stigma, and worse stress management ability, all of which were associated with greater depressive symptoms. A serial mediation with more microaggression-related stress being associated with greater internalized LGBTQ stigma approached significance. CONCLUSIONS Our findings generally support MST processes in terms of depressive symptoms in SGM adolescents of color, suggesting that psychosocial interventions targeting these processes may have meaningful implications for the mental health of this vulnerable group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | - Sharon Y. Lee
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT
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Marzetti H, Cooper C, Mason A, van Eijk NL, Gunn Iii J, Kavalidou K, Zortea TC, Nielsen E. LGBTQ+ Suicide - A Call to Action for Researchers and Governments on the Politics, Practices, and Possibilities of LGBTQ+ Suicide Prevention. CRISIS 2024; 45:87-92. [PMID: 38487858 DOI: 10.1027/0227-5910/a000950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Affiliation(s)
- Hazel Marzetti
- School of Health in Social Sciences, University of Edinburgh, UK
| | - Charlie Cooper
- Orygen, Centre for Youth Mental Health, University of Melbourne, VIC, Australia
- School of Educational Psychology and Counselling, Monash University, Melbourne, VIC, Australia
| | - Andre Mason
- Department of Psychological Medicine, University of Otago, New Zealand
| | | | - John Gunn Iii
- Department of Psychology, Gwynedd Mercy University, PA, USA
| | - Katerina Kavalidou
- National Suicide Research Foundation, WHO Collaborating Centre for Surveillance and Research in Suicide Prevention, University College Cork, Ireland
| | - Tiago C Zortea
- The Oxford Institute of Clinical Psychology Training and Research, University of Oxford, UK
| | - Emma Nielsen
- Institute for Mental Health, University of Nottingham, UK
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Hatzenbuehler ML, Lattanner MR, McKetta S, Pachankis JE. Structural stigma and LGBTQ+ health: a narrative review of quantitative studies. Lancet Public Health 2024; 9:e109-e127. [PMID: 38307678 DOI: 10.1016/s2468-2667(23)00312-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 02/04/2024]
Abstract
Health disparities related to sexual orientation and gender identity exist across multiple outcomes. Scholarship has begun to evaluate whether structural stigma-ie, societal-level conditions, cultural norms, and institutional policies that constrain opportunities, resources, and wellbeing-contributes to health burdens among LGBTQ+ individuals. We conducted a comprehensive review of quantitative studies examining this hypothesis. We found 98 articles that linked objective (ie, non-self-reported) measures of structural stigma to mental (n=57), behavioural (ie, substance use; n=27; HIV/AIDS or sexually transmitted infection; n=20), and physical (n=20) health outcomes. There was generally consistent evidence that structural stigma increases risk of poor health among LGBTQ+ individuals. Several methodological strengths were identified, including the use of multiple measures (eg, laws or policies [59%, 58 of 98]), designs (eg, quasi-experiments [21%, 21 of 98]), and samples (eg, probability-based [56%, 55 of 98]). However, important gaps exist. Just over half of studies included area-level covariates or non-LGBTQ+ comparison groups, which are necessary to address alternative explanations for the observed associations. Additionally, while studies (n=90) have begun to identify candidate mechanisms, only nine (10%) formally tested mediation. We offer suggestions for future research to advance this literature, which has implications not only for the identification of structural determinants of LGBTQ+ health but also for the development of public health interventions that reduce LGBTQ+ health disparities.
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Affiliation(s)
| | - Micah R Lattanner
- Department of Public Health, Santa Clara University, Santa Clara, CA, USA
| | - Sarah McKetta
- Department of Population Medicine, Harvard University, Boston, MA, USA
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Gordon JH, Tran KT, Visoki E, Argabright ST, DiDomenico GE, Saiegh E, Hoffman KW, Erez G, Barzilay R. The Role of Individual Discrimination and Structural Stigma in the Mental Health of Sexual Minority Youth. J Am Acad Child Adolesc Psychiatry 2024; 63:231-244. [PMID: 37422106 PMCID: PMC10770287 DOI: 10.1016/j.jaac.2023.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/30/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE Sexual minority (SM) youth experience a greater mental health burden compared with their heterosexual peers. This study aimed to characterize mental health disparities among SM compared with non-SM youth, test main and interactive associations of SM identity and stressors targeting SM youth at the individual level (interpersonal SM discrimination) and structural level (state-level structural SM stigma) with youth mental health, and explore the contribution of interpersonal SM discrimination to the mental health burden of SM youth. METHOD Participants included 11,622 youth (ages 9-13; 47.6% assigned female at birth) from the Adolescent Brain Cognitive Development (ABCD) Study. Linear mixed-effects models tested main and interactive associations of SM identity, interpersonal SM discrimination, and structural SM stigma with mental health measures (self-reported overall psychopathology, suicidal ideation, and suicide attempts), adjusting for demographics and other interpersonal stressors not specific to SM (other discrimination types, peer victimization, and cyberbullying). Longitudinal mediation models tested whether interpersonal SM discrimination mediated the associations between SM identity and mental health measures. RESULTS SM youth (n = 1,051) experienced more interpersonal SM discrimination and overall psychopathology compared with their non-SM peers (n = 10,571). Adjusting for demographics, there were significant associations (main effects) of interpersonal SM discrimination and structural SM stigma with overall psychopathology. When further adjusting for other non-SM-related stressors, the main effect of structural SM stigma was no longer significant. Interpersonal SM discrimination was also significantly associated with suicidal ideation and attempt, accounting for demographics, while structural SM stigma was not. Accounting for both demographics and other non-SM stressors, there was a significant interaction between SM identity and structural SM stigma in association with psychopathology (p = .02), such that, compared with their peers, SM youth showed a greater association between structural SM stigma and psychopathology. Longitudinal mediation revealed that interpersonal SM discrimination was a significant mediator explaining approximately 10% to 15% of the variance of the pathways between SM identity and all mental health outcomes. CONCLUSION Results delineate contributions of interpersonal discrimination and structural stigma targeting SM youth to their heightened mental health burden in early adolescence. These findings underscore the need to address microlevel and macrolevel SM discrimination and structural stigma when caring for this population. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.
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Affiliation(s)
- Joshua H Gordon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kate T Tran
- Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania; Lifespan Brain Institute of CHOP, and Penn Medicine, Philadelphia, Pennsylvania
| | - Elina Visoki
- Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania; Lifespan Brain Institute of CHOP, and Penn Medicine, Philadelphia, Pennsylvania
| | - Stirling T Argabright
- Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania; Lifespan Brain Institute of CHOP, and Penn Medicine, Philadelphia, Pennsylvania
| | - Grace E DiDomenico
- Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania; Lifespan Brain Institute of CHOP, and Penn Medicine, Philadelphia, Pennsylvania
| | - Eugenia Saiegh
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kevin W Hoffman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania
| | - Galit Erez
- Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel
| | - Ran Barzilay
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania; Lifespan Brain Institute of CHOP, and Penn Medicine, Philadelphia, Pennsylvania.
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Martino RM, Weissman DG, McLaughlin KA, Hatzenbuehler ML. Associations Between Structural Stigma and Psychopathology Among Early Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-11. [PMID: 37916808 PMCID: PMC11063121 DOI: 10.1080/15374416.2023.2272936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Ample evidence demonstrates that structural stigma - defined as societal-level conditions, cultural norms, and institutional policies and practices that constrain opportunities, resources, and well-being of stigmatized populations - is associated with psychopathology in adults from marginalized groups. Yet there is limited research on whether structural stigma is similarly associated with internalizing and externalizing symptoms among youth. METHOD Structural stigma related to sex, sexual orientation, race, and Latinx ethnicity was measured using indicators of state-level policy and aggregated attitudes. Using data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,414; M age = 12 years, SD = 0.66; 48% female, 6.8% lesbian, gay, and bisexual (LGB), 13.4% Black, 20% Latinx), we examined associations of structural stigma with internalizing and externalizing symptoms among female, LGB, Black, and Latinx youth. RESULTS LGB youth living in higher (vs. lower) structural stigma states had elevated levels of internalizing and externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between LGB and heterosexual youth. Similarly, Latinx youth and females living in higher (vs. lower) structural stigma states had elevated levels of externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between Latinx youth and non-Latinx White youth. Structural stigma related to race was unrelated to internalizing or externalizing symptoms for Black youth. CONCLUSIONS This study provides novel evidence that macro-level social environments, in the form of structural stigma, contribute to adverse mental health outcomes for marginalized youth and partly explain disparities in externalizing symptoms.
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Price MN, Green AE, DeChants JP, Davis CK. Physical Dating Violence Victimization among LGBTQ Youth: Disclosure and Association with Mental Health. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231162655. [PMID: 37032552 DOI: 10.1177/08862605231162655] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Youth dating violence and youth suicide are both major public health concerns. However, little research examines the intersection of these issues among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth. The current study examined the association between physical dating violence victimization and mental health using online survey data collected from 39,126 LGBTQ youth of ages 13 to 24 in the United States. Overall, 11% of LGBTQ youth who were in a relationship in the past year experienced physical dating violence victimization, with 4% having experienced it once and 7% having experienced it multiple times. Rates of experiencing physical dating violence victimization varied based on a number of youth characteristics and environmental factors. Past-year physical dating violence victimization was associated with nearly four times the odds of attempting suicide in the past year. Given the intersection of suicide risk and dating violence among LGBTQ youth, dating violence prevention organizations must be LGBTQ-inclusive, and suicide prevention must be equipped to address dating violence victimization. The higher rates of physical dating violence victimization among multiple marginalized and socioeconomically disadvantaged LGBTQ youth suggest the need for an intersectional approach that addresses the structural factors that place LGBTQ youth at risk for physical dating violence.
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Duncan DT, Cook SH, Wood EP, Regan SD, Chaix B, Tian Y, Chunara R. Structural racism and homophobia evaluated through social media sentiment combined with activity spaces and associations with mental health among young sexual minority men. Soc Sci Med 2023; 320:115755. [PMID: 36739708 PMCID: PMC10014849 DOI: 10.1016/j.socscimed.2023.115755] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Research suggests that structural racism and homophobia are associated with mental well-being. However, structural discrimination measures which are relevant to lived experiences and that evade self-report biases are needed. Social media and global-positioning systems (GPS) offer opportunity to measure place-based negative racial sentiment linked to relevant locations via precise geo-coding of activity spaces. This is vital for young sexual minority men (YSMM) of color who may experience both racial and sexual minority discrimination and subsequently poorer mental well-being. METHODS P18 Neighborhood Study (n = 147) data were used. Measures of place-based negative racial and sexual-orientation sentiment were created using geo-located social media as a proxy for racial climate via socially-meaningfully-defined places. Exposure to place-based negative sentiment was computed as an average of discrimination by places frequented using activity space measures per person. Outcomes were number of days of reported poor mental health in last 30 days. Zero-inflated Poisson regression analyses were used to assess influence of and type of relationship between place-based negative racial or sexual-orientation sentiment exposure and mental well-being, including the moderating effect of race/ethnicity. RESULTS We found evidence for a non-linear relationship between place-based negative racial sentiment and mental well-being among our racially and ethnically diverse sample of YSMM (p < .05), and significant differences in the relationship for different race/ethnicity groups (p < .05). The most pronounced differences were detected between Black and White non-Hispanic vs. Hispanic sexual minority men. At two standard deviations above the overall mean of negative racial sentiment exposure based on activity spaces, Black and White YSMM reported significantly more poor mental health days in comparison to Hispanic YSMM. CONCLUSIONS Effects of discrimination can vary by race/ethnicity and discrimination type. Experiencing place-based negative racial sentiment may have implications for mental well-being among YSMM regardless of race/ethnicity, which should be explored in future research including with larger samples sizes.
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Affiliation(s)
- Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, NewYork, NY, USA
| | - Stephanie H Cook
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA; Department of Biostatistics, New York University School of Global Public Health, New York, NY, USA
| | - Erica P Wood
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA
| | - Seann D Regan
- Department of Epidemiology, Columbia University Mailman School of Public Health, NewYork, NY, USA
| | - Basile Chaix
- French National Institute of Health and Medical Research (INSERM), Sorbonne Université, Institut Pierre Louis D'Epidémiologie et de Santé Publique IPLESP, Nemesis Team, F75012, Paris, France
| | - Yijun Tian
- Department of Computer Science and Engineering, New York University Tandon School of Engineering, New York, NY, USA
| | - Rumi Chunara
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, USA; Department of Computer Science and Engineering, New York University Tandon School of Engineering, New York, NY, USA.
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White J, Borgia S, Rehkopf DH. Socioeconomic inequalities in the risk of suicide attempts among sexual minority adolescents: Findings from the UK's Millennium Cohort Study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 26:100570. [PMID: 36619211 PMCID: PMC9813783 DOI: 10.1016/j.lanepe.2022.100570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022]
Abstract
Background Both sexual minority and socioeconomically deprived young people are at an increased risk of making a suicide attempt. Intersectionality theory predicts these risk factors will interact synergistically to create unique vulnerabilities. We investigated the risk of suicide attempts in sexual minority socioeconomically deprived young people in a contemporary national cohort. Methods The Millennium Cohort Study (MCS) is a birth cohort study in the UK following children born 2000-2002. Children in the MCS have been followed up over seven sweeps to date at ages 9 months, 3, 5, 7, 11, 14 and 17 years. The relative risk (RR) of self-reported suicide attempts at 17 years by sexual minority status and parental unemployment was estimated using multivariable log-binomial regression. Additive interaction, representing the synergistic effect, was estimated using the relative excess risk due to interaction (RERI). Findings Between January, 2018 and March, 2019, 10,247 adolescents provided their sexuality and parents their employment status. 758 (7.4%) of 10,247 adolescents had made a suicide attempt. Relative to heterosexual young people living with no unemployed parents, the RR for sexual minorities living with no unemployed parents/carers was 2.93 (95% CI 2.26-3.79), one unemployed was 4.46 (95% CI 2.94-6.77), and two was 6.35 (95% CI 3.62-11.14). There was evidence of a positive additive interaction. The RERI for having one unemployed parent was 1.08 (95% CI -0.54 to 2.69) and two was 3.10 (95% CI -1.58 to 7.78). Sensitivity analyses using housing tenure and in a sample with no missing data generated comparable results. Interpretation To our knowledge, this is the first evidence that socioeconomically deprived sexual minority adolescents are uniquely vulnerable to making a suicide attempt. Health and educational practitioners need to be aware of the increased risk of suicide attempts in socioeconomically deprived sexual minority adolescents. Funding Economic and Social Research Council (ESRC).
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Affiliation(s)
- James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Sophie Borgia
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - David H. Rehkopf
- Department of Epidemiology and Population Health, Department of Medicine, Department of Sociology, Center for Population Health Sciences, Stanford University, Stanford, USA
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Storholm ED, Huang W, Ogunbajo A, Horvath KJ, Reback CJ, Blumenthal J, Moore DJ, Flynn RP, Bolan RK, Corado KC, Morris SR. Gender-Based Violence and Post-traumatic Stress Disorder Symptoms Predict HIV PrEP Uptake and Persistence Failure Among Transgender and Non-binary Persons Participating in a PrEP Demonstration Project in Southern California. AIDS Behav 2023; 27:745-759. [PMID: 36053404 PMCID: PMC9908815 DOI: 10.1007/s10461-022-03807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
Gender-based violence (GBV) against transgender and nonbinary (TGNB) persons is a pervasive public health issue. GBV has been linked to mental health problems such as depression and posttraumatic stress disorder (PTSD), as well has risk for HIV seroconversion and HIV treatment nonadherence. However, the impact of GBV on HIV pre-exposure prophylaxis (PrEP) use among TGNB persons has yet to be investigated. In the current study we assessed longitudinal PrEP persistence data from dried blood spots (DBS) collected from 172 racially and ethnically diverse TGNB participants during a 48-week PrEP demonstration project in Southern California from June 2017 to September 2020. Participants were categorized into three levels of PrEP uptake and persistence based on their PrEP levels at the start and end of the study: low-low, high-low, and high-high. Individual-, social-, and structural-level variables were then entered into multinomial logistic regression models to predict levels of PrEP uptake and persistence based on hypotheses informed by syndemic and minority stress theories. The models demonstrated that experience of GBV predicted significantly lower odds of PrEP uptake and persistence and greater PTSD symptoms predicted significantly greater odds of early PrEP discontinuation. Higher levels of coping skills, already being on PrEP at baseline, and being in a steady relationship were associated with greater odds of PrEP uptake and persistence. Implications for future GBV research, advocacy, interventions, and much needed structural changes focused on improving the health and safety of TGNB individuals are discussed.
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Affiliation(s)
- Erik D Storholm
- School of Public Health, San Diego State University, San Diego, CA, USA.
- RAND Corporation, Santa Monica, CA, USA.
- Center for HIV Identification, Prevention and Treatment Services, Department of Family Medicine, University of California Los Angeles, Los Angeles, CA, USA.
| | | | - Adedotun Ogunbajo
- RAND Corporation, Santa Monica, CA, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Cathy J Reback
- Center for HIV Identification, Prevention and Treatment Services, Department of Family Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Friends Research Institute, Los Angeles, CA, USA
| | - Jill Blumenthal
- AntiViral Research Center, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - David J Moore
- AntiViral Research Center, University of California, San Diego School of Medicine, San Diego, CA, USA
| | | | | | | | - Sheldon R Morris
- AntiViral Research Center, University of California, San Diego School of Medicine, San Diego, CA, USA
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Flores AR, Stotzer RL, Meyer IH, Langton LL. Hate crimes against LGBT people: National Crime Victimization Survey, 2017-2019. PLoS One 2022; 17:e0279363. [PMID: 36542637 PMCID: PMC9770371 DOI: 10.1371/journal.pone.0279363] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
We estimate the prevalence and characteristics of violent hate crime victimization of lesbian, gay, bisexual, and transgender (LGBT) people in the United States, and we compare them to non-LGBT hate crime victims and to LGBT victims of violent non-hate crime. We analyze pooled 2017-2019 data from the National Crime Victimization Survey (n persons = 553, 925;n incidents = 32, 470), the first nationally representative and comprehensive survey on crime that allows identification of LGBT persons aged 16 or older. Descriptive and bivariate analysis show that LGBT people experienced 6.6 violent hate crime victimizations per 1,000 persons compared with non-LGBT people's 0.6 per 1,000 persons (odds ratio = 8.30, 95% confidence interval = 1.94, 14.65). LGBT people were more likely to be hate crime victims of sexual orientation or gender bias crime and less likely to be victims of race or ethnicity bias crimes compared to non-LGBT hate crime victims. Compared to non-LGBT victims, LGBT victims of hate crime were more likely to be younger, have a relationship with their assailant, and have an assailant who is white. Compared to LGBT victims of non-hate violence, more LGBT hate crime victims reported experiencing problems in their social lives, negative emotional responses, and physical symptoms of distress. Our findings affirm claims that hate crimes have adverse physical and psychological effects on victims and highlight the need to ensure that LGBT persons who experience hate crime get necessary support and services in the aftermath of the crime.
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Affiliation(s)
- Andrew R. Flores
- Department of Government, School of Public Affairs, American University, Washington, District of Columbia, United States of America
- The Williams Institute, UCLA School of Law, Los Angeles, California, United States of America
- * E-mail:
| | - Rebecca L. Stotzer
- The Thompson School of Social Work and Public Health, University of Hawai’i, Mānoa, Honolulu, Hawai’i, United States of America
| | - Ilan H. Meyer
- The Williams Institute, UCLA School of Law, Los Angeles, California, United States of America
| | - Lynn L. Langton
- RTI International, Washington, District of Columbia, United States of America
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14
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Huber BD, Kim B, Chaix B, Regan SD, Duncan DT. Objective and Subjective Neighborhood Crime Associated with Poor Sleep among Young Sexual Minority Men: a GPS Study. J Urban Health 2022; 99:1115-1126. [PMID: 35931941 PMCID: PMC9727059 DOI: 10.1007/s11524-022-00674-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 01/14/2023]
Abstract
Sleep disparities in sexual minority male (SMM) populations have received relatively little attention but they may be critical to explaining other health disparities seen among SMM, via neural or hormonal pathways. Recent research suggests that crime may be a psychosocial stressor that contributes to sleep disparities but that finding has been based on subjective measures of crime. We conducted the P18 Neighborhood Study of 250 SMM in New York City, including 211 with adequate GPS tracking data. We used the GPS tracking data to define daily path area activity spaces and tested the associations of violent crime in those activity spaces and in the subject's residential neighborhood, perceived neighborhood safety, and witnessing crime with a subjective measure of sleep. Using quasi-Poisson regression, adjusted for individual and neighborhood socio-demographics, we found that SMM who witnessed more types of crime experienced significantly more nights of poor sleep over the course of a month (RR: 1.16, 95%CI: 1.05-1.27, p-value: < 0.01). We did not find any associations between violent crime rates in either the activity area or residential area and sleep. Our findings support the conclusion that personal exposure to crime is associated with sleep problems and provide further evidence for the pathway between stress and sleep. The lack of association between neighborhood crime levels and sleep suggests that there must be personal experience with crime and ambient presence is insufficient to produce an effect.
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Affiliation(s)
- Benjamin D Huber
- Department of Epidemiology, Columbia Spatial Epidemiology Lab, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA.
| | - Byoungjun Kim
- Department of Epidemiology, Columbia Spatial Epidemiology Lab, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA
- Department of Population Health, New York University Grossman School of Medicine, 550 1st Ave, New York, NY, 10016, USA
| | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique IPLESP, Nemesis team, F75012, Paris, France
| | - Seann D Regan
- Department of Epidemiology, Columbia Spatial Epidemiology Lab, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia Spatial Epidemiology Lab, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA
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15
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Prince DM, Ray-Novak M, Gillani B, Peterson E. Sexual and Gender Minority Youth in Foster Care: An Evidence-Based Theoretical Conceptual Model of Disproportionality and Psychological Comorbidities. TRAUMA, VIOLENCE & ABUSE 2022; 23:1643-1657. [PMID: 33942681 DOI: 10.1177/15248380211013129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual and gender minority youth (SGMY) are overrepresented in the foster care system and experience greater foster-care-related stressors than their non-SGM peers. These factors may further elevate their risk of anxiety/depressive, post-traumatic stress disorder, self-harm, and suicidality. The system currently produces unequal and disproportionate adverse mental health outcomes for SGMY and needs points of intervention to disrupt this status quo. This article provides an empirically grounded conceptual-theoretical model of disproportionate representation and burden of psychological comorbidities experienced by SGMY in the foster care system. We apply findings from an integrated literature review of empirical research on factors related to overrepresentation and mental health burden among SGMY to minority stress theory to explicate how and why the foster care system exacerbates mental health comorbidities for SGMY. Searches were conducted in June 2020 in PubMed using MeSH terms and title/abstract terms for foster care, sexual or gender minorities, and psychological comorbidities. Inclusion criteria are studies conducted in the United States, published in English, focused on mental illness, and published between June 2010 and 2020. Developmental/intellectual and eating disorders were excluded. The initial search returned 490 results. After applying inclusion criteria, 229 results remained and are utilized to build our conceptual-theoretical model. We assert that the phenomenon of disproportionate psychological comorbidities for SGMY in foster care is best represented as a complex and dynamic system with multiple feedback loops. Extant empirical and theoretical literature identifies three critical areas for intervention: family acceptance, community belonging and queer chosen/constructed family, and affirming and nondiscriminatory child welfare policy.
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Affiliation(s)
- Dana M Prince
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 2546Case Western Reserve University, Cleveland, OH, USA
| | - Meagan Ray-Novak
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 2546Case Western Reserve University, Cleveland, OH, USA
| | - Braveheart Gillani
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 2546Case Western Reserve University, Cleveland, OH, USA
| | - Emily Peterson
- Department of Psychological Sciences, 2546Case Western Reserve University, Cleveland, OH, USA
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16
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Kundu A, Fu R, Grace D, Logie CH, Abramovich A, Baskerville B, Yager C, Schwartz R, Mitsakakis N, Planinac L, Chaiton M. Correlates of wanting to seek help for mental health and substance use concerns by sexual and gender minority young adults during the COVID-19 pandemic: A machine learning analysis. PLoS One 2022; 17:e0277438. [PMID: 36383536 PMCID: PMC9668172 DOI: 10.1371/journal.pone.0277438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has worsened the mental health and substance use challenges among many people who are Two Spirit, lesbian, gay, bisexual, transgender, queer, questioning, and intersex (2SLGBTQI+). We aimed to identify the important correlates and their effects on the predicted likelihood of wanting to seek help among 2SLGBTQI+ young adults for mental health or substance use concerns during the pandemic. A cross-sectional survey was conducted in 2020-2021 among 2SLGBTQI+ young adults aged 16-29 living in two Canadian provinces (Ontario and Quebec). Among 1414 participants, 77% (n = 1089) wanted to seek help for their mental health or substance use concerns during the pandemic, out of these, 69.8% (n = 760) reported delay in accessing care. We built a random forest (RF) model to predict the status of wanting to seek help, which achieved moderately high performance with an area under the receiver operating characteristic curve (AUC) of 0.85. The top 10 correlates of wanting to seek help were worsening mental health, age, stigma and discrimination, and adverse childhood experiences. The interactions of adequate housing with certain sexual orientations, gender identities and mental health challenges were found to increase the likelihood of wanting to seek help. We built another RF model for predicting risk of delay in accessing care among participants who wanted to seek help (n = 1089). The model identified a similar set of top 10 correlates of delay in accessing care but lacked adequate performance (AUC 0.61). These findings can direct future research and targeted prevention measures to reduce health disparities for 2SLGBTQI+ young adults.
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Affiliation(s)
- Anasua Kundu
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada
| | - Rui Fu
- Department of Otolaryngology—Head and Neck Surgery, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Carmen H. Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- United Nations University Institute for Water, Environment & Health, Hamilton, Canada
| | - Alex Abramovich
- Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Bruce Baskerville
- Canadian Institutes of Health Research, Ottawa, Canada
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, Canada
| | | | - Robert Schwartz
- Centre for Addiction and Mental Health, Toronto, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Nicholas Mitsakakis
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Lynn Planinac
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada
| | - Michael Chaiton
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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17
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Lett E, Abrams MP, Moberg E, Benson GP, Perlson JE. Syndemic relationship of depressive symptoms, substance use, and suicidality in transgender youth: a cross-sectional study using the U.S. youth risk behavior surveillance system. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2293-2304. [PMID: 35962805 DOI: 10.1007/s00127-022-02348-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Syndemics are co-occurring epidemics that cluster within populations due to shared socio-structural factors and are often in populations with intersecting forms of vulnerability. Suicide, depression, and substance use all disproportionately affect transgender and gender diverse (TGD) youth. In this study, we test a syndemic model of the relationship between these three mental health conditions in the context of economic deprivation and interpersonal discrimination. METHODS We used data on substance use, depressive symptoms, suicidality, and social-structural factors from 2680 TGD youth captured in the 2017 and 2019 survey waves of the Youth Risk Behavior Surveillance System. We used a latent class analysis (LCA) to identify groups with distinct patterns of self-reported substance use and depressive symptoms, and regression models to characterize the relationship between substance-use, depressive symptoms, class membership, social-structural factors, and suicidality. RESULTS A three-class LCA solution identified a subset of student respondents in a "high use" latent class characterized by high self-reported substance use frequency and depressive symptoms compared with other classes. Online bullying (aOR: 1.58; 95% CI: 1.28-1.95) and housing insecurity (aOR: 8.78; 95% CI: 4.35-17.71) were associated with increased odds of "high use" class membership relative to the "no use" class membership. "High use" class membership was associated with increased odds of suicidal ideation (aOR: 2.26; 95% CI: 1.75-2.94), plans (aOR: 2.59; 95% CI: 2.01-3.36), and attempts (aOR: 6.85; 95% CI: 3.17-15.68). CONCLUSION The co-occurrence of substance use and depressive symptoms is associated with socio-structural factors and may drive risk for suicidality among TGD youth. Meaningful suicide prevention efforts that address disproportionate risk in this population must be attentive to and mitigate the shared determinants of mood symptoms and substance use behavior.
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Affiliation(s)
- Elle Lett
- Perelman School of Medicine, University of Pennsylvania, Blockley Hall, Philadelphia, PA, 19146, USA. .,Center for Applied Transgender Studies, Chicago, IL, USA.
| | - Matthew P Abrams
- Center for Emergency Care Policy and Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Penn Medicine Center for Digital Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Emery Moberg
- Unaffiliated Recent College Graduate, Los Angeles, CA, USA
| | - G Perusi Benson
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
| | - Jacob E Perlson
- Department of Psychiatry, Columbia University, New York, NY, USA
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18
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Price MA, Hollinsaid NL. Future Directions in Mental Health Treatment with Stigmatized Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:810-825. [PMID: 36007234 PMCID: PMC9835015 DOI: 10.1080/15374416.2022.2109652] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Stigma refers to societally-deemed inferiority associated with a circumstance, behavior, status, or identity. It manifests internally, interpersonally, and structurally. Decades of research indicate that all forms of stigma are associated with heightened risk for mental health problems (e.g., depression, PTSD, suicidality) in stigmatized youth (i.e., children, adolescents, and young adults with one or more stigmatized identities, such as youth of Color and transgender youth). Notably, studies find that stigmatized youth living in places with high structural stigma - defined as laws/policies and norms/attitudes that hurt stigmatized people - have a harder time accessing mental health treatment and are less able to benefit from it. In order to reduce youth mental health inequities, it is imperative for our field to better understand, and ultimately address, stigma at each of these levels. To facilitate this endeavor, we briefly review research on stigma and youth mental health treatment, with an emphasis on structural stigma, and present three future directions for research in this area: (1) directly addressing stigma in treatment, (2) training therapists in culturally responsive care, and (3) structural interventions. We conclude with recommendations for best practices in broader mental health treatment research.
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Affiliation(s)
- Maggi A. Price
- School of Social Work, Boston College, Boston, MA
- Department of Psychology, Harvard University, Cambridge, MA
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19
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Kundu A, Fu R, Grace D, Logie C, Abramovich A, Baskerville B, Yager C, Schwartz R, Mitsakakis N, Planinac L, Chaiton M. Correlates of past year suicidal thoughts among sexual and gender minority young adults: A machine learning analysis. J Psychiatr Res 2022; 152:269-277. [PMID: 35759979 DOI: 10.1016/j.jpsychires.2022.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/27/2022] [Accepted: 06/07/2022] [Indexed: 01/14/2023]
Abstract
Sexual and gender minority populations are at elevated risk of experiencing suicidal thoughts and attempting suicide. The COVID-19 pandemic exacerbated mental health and substance use challenges among this population. We aimed to examine the relative importance and effects of intersectional factors and strong interactions associated with the risk of suicidal thoughts among Canadian lesbian, gay, bisexual, transgender, queer, questioning, intersex and Two Spirit (LGBTQI2S+) young adults. A cross-sectional online survey was conducted among LGBTQI2S + participants aged 16-29 years living in two Canadian provinces (Ontario, Quebec). Among 1414 participants (mean age 21.90 years), 61% (n = 857) participants reported suicidal thoughts in last 12 months. We built a random forest model to predict the risk of having past year suicidal thoughts, which achieved high performance with an area under the receiver operating characteristic curve (AUC) of 0.84. The top 10 correlates identified were: seeking help from health professionals for mental health or substance use issues since the start of the pandemic, current self-rated mental health status, insulted by parents or adults in childhood, ever heard that being identifying as LGBTQI2S+ is not normal, age in years, past week feeling depressed, lifetime diagnosis of mental illness, lifetime diagnosis of depressive disorder, past week feeling sad, ever pretended to be straight or cisgender to be accepted. The increase in the risk of suicidal thoughts for those having mental health challenges or facing minority stressors is more pronounced in those living in urban areas or being unemployed than those living in rural areas or being employed.
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Affiliation(s)
- Anasua Kundu
- Institute of Medical Science, University of Toronto, Toronto, Canada; Centre for Addiction and Mental Health, Toronto, Canada; Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada.
| | - Rui Fu
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Research Institute, University of Toronto, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Carmen Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada; United Nations University Institute for Water, Environment & Health, Hamilton, Canada
| | - Alex Abramovich
- Centre for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada
| | - Bruce Baskerville
- Canadian Institutes of Health Research, Ottawa, Canada; School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, Canada
| | | | - Robert Schwartz
- Centre for Addiction and Mental Health, Toronto, Canada; Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada
| | - Nicholas Mitsakakis
- Dalla Lana School of Public Health, University of Toronto, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Lynn Planinac
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada
| | - Michael Chaiton
- Centre for Addiction and Mental Health, Toronto, Canada; Ontario Tobacco Research Unit, University of Toronto, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada
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20
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Wenger MR, Lantz B. Hate Crime and Place: The Spatial and Temporal Concentration of Bias-Motivated Crime in Washington, D.C. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP10683-NP10708. [PMID: 33467956 DOI: 10.1177/0886260520987817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Prior research suggests that many crime types are spatially concentrated and stable over time. Hate crime, however, is a unique crime type that is etiologically distinct from others. As such, examination of hate crime from a spatial and temporal perspective offers an opportunity to understand hate crime and the spatial concentration of crime more generally. The current study examines the spatial stability of hate crimes reported to the police in Washington, D.C., from 2012 through 2018 using street segments, intersections, and block groups as units of analysis. Findings reveal that hate crime is spatially concentrated, with less than 4% of street segments and intersections experiencing hate crime over the study period. Results reveal a high degree of spatial stability, both year-to-year and over the long term even when restricting the analysis to units that experienced at least one hate crime.
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21
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Lockwood S, Cuevas CA. Hate Crimes and Race-Based Trauma on Latinx Populations: A Critical Review of the Current Research. TRAUMA, VIOLENCE & ABUSE 2022; 23:854-867. [PMID: 33325321 DOI: 10.1177/1524838020979688] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Traditionally, the literature has sought to understand the impact of racial minority status and trauma as it relates to interpersonal violence, domestic violence, and sexual assault. What has not been as extensively reviewed and summarized is how racially or ethnically motivated hate crimes impact the mental health of minorities-particularly Latinx/Hispanic groups. This review aims to summarize the current body of literature on the intersection of race-motivated hate crime and trauma responses within Latinx community. To do so, the theoretical foundation for this inquiry will build from a race-based trauma perspective. Specifically, this review connects existing frameworks for race and trauma and integrates literature that examines Latinx or Hispanic populations that have experienced discrimination, bias, or hate crime as a result of their identity or perceived identity. The importance of situating bias or hate events within the trauma literature stems from a lack of overall formal evaluation of these events, and how these occurrences are historically overlooked as a traumatic stressor. The findings of this review suggest that (1) experiencing racially motivated victimization can cause adverse mental and physical health outcomes in Latinxs and (2) currently, there is only one study that has examined the impact of hate crime on Latinxs in the United States. This leaves the field with unanswered questions about the impact of hate crime victimization among Latinxs, which is an ever-growing area in need of attention.
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Affiliation(s)
- Sarah Lockwood
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
| | - Carlos A Cuevas
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
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22
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Marchi M, Arcolin E, Fiore G, Travascio A, Uberti D, Amaddeo F, Converti M, Fiorillo A, Mirandola M, Pinna F, Ventriglio A, Galeazzi GM. Self-harm and suicidality among LGBTIQ people: a systematic review and meta-analysis. Int Rev Psychiatry 2022; 34:240-256. [PMID: 36151841 DOI: 10.1080/09540261.2022.2053070] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Research evidence has consistently documented a higher risk of suicidality in the Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) population. This systematic review and meta-analysis aimed to report a detailed description of research data regarding the risk of Attempted Suicide (SA), Suicide Ideation (SI), and Non-Suicidal Self-Injury (NSSI) behaviours for LGBTIQ people and their subgroups. Medline, Scopus, PsycINFO, and EMBASE were searched for studies reporting a comparative estimation of SA, SI, and NSSI rates among LGBTIQ population and the general population (i.e. heterosexual/cisgender), without restrictions on participants' age and setting for the enrolment. Pooled analyses were based on odds ratios (ORs, with 95% CIs), estimated through inverse variance models with random effects. Fifty studies were selected for the quantitative synthesis and included fifty samples involving 3.735.601 controls and 87.252 LGBTIQ people. LGBTIQ people reported an increased risk of SA (OR:4.36[95%CI:3.32;5.71]), SI (OR:3.76[95%CI:3.02;4.69]), and NSSI (OR:4.24[95%CI:3.23;5.55]). Among LGBTIQ subgroups, the Bisexual group has shown the highest risk of suicidality (SA, OR:6.71; SI, OR:5.04; NSSI, OR: 5.03), followed by the Lesbian-Gay for attempted suicide (SA, OR:6.03), and the Transgender-Intersex-Queer for suicide ideation and non-suicidal self-injury (SI and NSSI, OR:3.42). The quality of the evidence ranged from low to moderate. Our findings have shown that LGBTIQ people report a higher risk of suicidality compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQI mental health needs and suggest supportive strategies as well as preventive interventions (e.g. supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity and mortality in this at-risk population.
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Affiliation(s)
- Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Arcolin
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianluca Fiore
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio Travascio
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Uberti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy.,School of Health Sciences, University of Brighton, Brighton, UK
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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23
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Ceballo R, Alers‐Rojas F, Mora AS, Cranford JA. Exposure to community violence: Toward a more expansive definition and approach to research. CHILD DEVELOPMENT PERSPECTIVES 2022. [DOI: 10.1111/cdep.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Rosario Ceballo
- Department of Psychology Georgetown University Washington District of Columbia USA
| | - Francheska Alers‐Rojas
- Department of Human Development and Family Sciences University of Texas at Austin Austin Texas USA
| | - Andrea S. Mora
- Department of Psychology University of Michigan Ann Arbor Michigan USA
| | - James A. Cranford
- Department of Emergency Medicine University of Michigan Ann Arbor Michigan USA
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24
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Chang CJ, Kellerman J, Feinstein BA, Selby EA, Goldbach JT. Greater Minority Stress is Associated with Lower Intentions to Disclose Suicidal Thoughts among LGBTQ + Youth. Arch Suicide Res 2022; 26:626-640. [PMID: 32970971 DOI: 10.1080/13811118.2020.1818656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The current study examined suicide-related disclosure intentions in LGBTQ + youth, and the associations between reporting of lifetime experiences of minority stress and intentions to disclose suicidal thoughts. METHOD A sample of 592 LGBTQ + youth ages 12-24 (22.3% cisgender men, 33.1% cisgender women, 44.6% gender diverse, 75.3% white) who contacted an LGBTQ-specific crisis service, completed a survey. RESULTS Youth reported highest intentions to disclose future suicidal ideation to LGBTQ-specific crisis services, a mental health professional, and someone they know who also identifies as LGBTQ. They reported lowest suicide-related disclosure intentions to family, spiritual counselors, and emergency room personnel. Greater lifetime minority stress was significantly associated with lower suicide-related disclosure intentions. When specific domains of minority stress were examined separately, five domains were significantly associated with lower suicide-related disclosure intentions: identity management, family rejection, homonegative communication, negative expectancies, and internalized homonegativity. However, only internalized homonegativity remained significant when they were examined simultaneously. In addition, greater lifetime minority stress was significantly associated with lower suicide-related disclosure intentions to some groups (e.g., family, friends), but not others (e.g., others who have thought about or attempted suicide, others who identify as LGBT). CONCLUSIONS Minority stress may play an important role in LGBTQ + youth's suicide-related disclosure intentions. As such, reducing minority stress and its effects may be an important target to promote disclosure of suicidal thoughts and access to treatment among LGBTQ + youth.HIGHLIGHTSMinority stress was associated with lower suicide-related disclosure intentions.Internalized homonegativity was uniquely associated with disclosure intentions.Reducing minority stress may promote disclosure of suicidal thoughts.
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Michaels EK, Board C, Mujahid MS, Riddell CA, Chae DH, Johnson RC, Allen AM. Area-level racial prejudice and health: A systematic review. Health Psychol 2022; 41:211-224. [PMID: 35254858 PMCID: PMC8930473 DOI: 10.1037/hea0001141] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
BACKGROUND In recent years, there has been growing interest in "moving beyond the individual" to measure area-level racism as a social determinant of health. Much of this work has aggregated racial prejudice data collected at the individual-level to the area-level. OBJECTIVE As this is a rapidly emerging area of research, we conducted a systematic literature review to describe evidence of the relationship between area-level racial prejudice and health, whether results differed by race/ethnicity, and to characterize key conceptual and methodological considerations to guide future research. METHOD We searched four interdisciplinary databases for US-based, peer-reviewed articles measuring area level racial prejudice by aggregating individual-level indicators of racial prejudice and examining associations with mental or physical health outcome(s). Data extraction followed PRISMA guidelines and also included theory and conceptualization, pathways to health, and strengths and limitations. RESULTS Fourteen of 14,632 identified articles met inclusion criteria and were included in the review. Health outcomes spanned all-cause (n = 4) and cause-specific (n = 4) mortality, birth outcomes (n = 4), cardiovascular outcomes (n = 2), mental health (n = 1), and self-rated health (n = 1). All studies found a positive association between area-level racial prejudice and adverse health outcomes among racial/ethnic minoritized groups, with four studies also showing a similar association among Whites. Engagement with formal theory was limited and exposure conceptualization was mixed. Methodological considerations included unmeasured confounding and trade-offs between generalizability, self-censorship, and specificity of measurement. CONCLUSIONS Future research should continue to develop the conceptual and methodological rigor of this work and test hypotheses to inform evidence-based interventions to advance population health and reduce racial health inequities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Eli K. Michaels
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Christine Board
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Mahasin S. Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Corinne A. Riddell
- Division of Epidemiology, School of Public Health, University of California, Berkeley
- Division of Biostatistics, School of Public Health, University of California, Berkeley
| | - David H. Chae
- Department of Global Community Health & Behavioral Sciences, Tulane School of Public Health and Tropical Medicine
| | | | - Amani M. Allen
- Division of Epidemiology, School of Public Health, University of California, Berkeley
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley
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Madireddy S, Madireddy S. Supportive model for the improvement of mental health and prevention of suicide among LGBTQ+ youth. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2025872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Walter-McCabe H, Chen A. EDITORS' INTRODUCTION: Transgender Health Equity and the Law. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2022; 50:401-408. [PMID: 36398648 PMCID: PMC9679591 DOI: 10.1017/jme.2022.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The sheer gamut of issues impacting transgender health equity may seem overwhelming. This article seeks to introduce readers to the breadth of topics addressed in this symposium edition, exemplifying that transgender health equity is a global issue that demands an interdisciplinary approach.
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Kundu A, Chaiton M, Billington R, Grace D, Fu R, Logie C, Baskerville B, Yager C, Mitsakakis N, Schwartz R. Machine Learning Applications in Mental Health and Substance Use Research Among the LGBTQ2S+ Population: Scoping Review. JMIR Med Inform 2021; 9:e28962. [PMID: 34762059 PMCID: PMC8663464 DOI: 10.2196/28962] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 09/02/2021] [Accepted: 10/03/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND A high risk of mental health or substance addiction issues among sexual and gender minority populations may have more nuanced characteristics that may not be easily discovered by traditional statistical methods. OBJECTIVE This review aims to identify literature studies that used machine learning (ML) to investigate mental health or substance use concerns among the lesbian, gay, bisexual, transgender, queer or questioning, and two-spirit (LGBTQ2S+) population and direct future research in this field. METHODS The MEDLINE, Embase, PubMed, CINAHL Plus, PsycINFO, IEEE Xplore, and Summon databases were searched from November to December 2020. We included original studies that used ML to explore mental health or substance use among the LGBTQ2S+ population and excluded studies of genomics and pharmacokinetics. Two independent reviewers reviewed all papers and extracted data on general study findings, model development, and discussion of the study findings. RESULTS We included 11 studies in this review, of which 81% (9/11) were on mental health and 18% (2/11) were on substance use concerns. All studies were published within the last 2 years, and most were conducted in the United States. Among mutually nonexclusive population categories, sexual minority men were the most commonly studied subgroup (5/11, 45%), whereas sexual minority women were studied the least (2/11, 18%). Studies were categorized into 3 major domains: web content analysis (6/11, 54%), prediction modeling (4/11, 36%), and imaging studies (1/11, 9%). CONCLUSIONS ML is a promising tool for capturing and analyzing hidden data on mental health and substance use concerns among the LGBTQ2S+ population. In addition to conducting more research on sexual minority women, different mental health and substance use problems, as well as outcomes and future research should explore newer environments, data sources, and intersections with various social determinants of health.
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Affiliation(s)
- Anasua Kundu
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Michael Chaiton
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rebecca Billington
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rui Fu
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Carmen Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Women's College Research Institute, Toronto, ON, Canada
| | - Bruce Baskerville
- Canadian Institutes of Health Research, Government of Canada, Ottawa, ON, Canada
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, ON, Canada
| | | | - Nicholas Mitsakakis
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Robert Schwartz
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
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Campbell C, Mena JA. LGBTQ+ Structural Stigma and College Counseling Center Website Friendliness. JOURNAL OF COLLEGE COUNSELING 2021. [DOI: 10.1002/jocc.12194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Baiden P, Jahan N, Mets VE, Adeku Y. An examination of the association between risky sexual behaviors and suicidal behaviors among adolescents: Findings from the 2017 Youth Risk Behavior Survey. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02328-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Embodied, Situated, and Co-Constructed: Young Sexual Minority Men’s Experiences of Intersectional Identity and Minority Stress. SEX ROLES 2021; 85:606-624. [DOI: 10.1007/s11199-021-01238-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mills CE. Gay Visibility and Disorganized and Strained Communities: A Community-Level Analysis of Anti-Gay Hate Crime in New York City. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:8070-8091. [PMID: 31084391 DOI: 10.1177/0886260519848784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recent years have seen increased attention to the problem of hate crime, including such crime motivated by anti-gay bias. Although there is a growing body of research regarding the context of hate crime offending, there is a relative dearth of work investigating the community-level context of anti-gay hate crime. The current study investigates the community-level determinants of anti-gay hate crime in New York City from 2006 to 2010, using data obtained from the New York Police Department (NYPD)'s Hate Crimes Task Force (HCTF), one of the nation's leading hate crime police units. Using a framework drawing on group conflict and criminological theories, the current study examines anti-gay hate crime as an outcome of gay visibility, social disorganization, and economic strain. It is hypothesized that greater gay visibility, as well as social disorganization and poor and worsening economic conditions over time will be associated with increases in anti-gay hate crime. Results show that gay demographics, measured by static visibility and increasing gay populations over time, are shown to consistently predict higher levels of anti-gay hate crime. Adding to the generally mixed findings on the role of economic conditions in explaining hate crime, this study also finds that anti-gay hate crime occurs in more disadvantaged communities and communities marked by poorer economic conditions. The findings show anti-gay hate crime to be an outcome of gay visibility, disadvantage, and poor economic conditions, indicating that anti-gay crime may be an angry response to the strains present in the community. The study concludes with a discussion of the findings and implications for policy makers and practitioners.
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Baiden P, Mengo C, Small E. History of Physical Teen Dating Violence and Its Association With Suicidal Behaviors Among Adolescent High School Students: Results From the 2015 Youth Risk Behavior Survey. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP9526-NP9547. [PMID: 31271096 DOI: 10.1177/0886260519860087] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although studies have investigated and found physical teen dating violence (TDV) has a significant negative impact on mental health outcomes, few studies are yet to investigate the effect of physical TDV on suicidal behaviors among adolescents. The objectives of this study are to examine the prevalence of physical TDV, suicidal ideation, suicide plan, and suicide attempt among adolescents aged 14 to 18 years and the association between physical TDV and these suicidal behaviors. Data for this study were obtained from the 2015 Youth Risk Behavior Survey. A sample of 9,693 adolescents aged 14 to 18 years (50.4% males) was analyzed using logistic regression with suicidal ideation, suicide plan, and suicide attempt as outcome variables and physical TDV as the main explanatory variable. About 17% of the adolescent students experienced suicidal ideation, 13.7% made a suicide plan, and 7.6% attempted suicide during the past 12 months. Among those who were dating, 9.9% experienced physical TDV. In the multivariate logistic regression, adolescent students who experienced physical TDV were 1.92 times more likely to have experienced suicidal ideation, 1.67 times more likely to have made a suicide plan, and 2.42 times more likely to have attempted suicide during the past 12 months when compared with their counterparts who were dating but experienced no physical TDV. Other significant predictors of suicidal behaviors include being a sexual minority, experiencing forced sex, bullying, feeling sad or hopeless, and binge drinking. Having sufficient sleep lowered the odds of suicidal ideation and suicide plan. The topic of physical TDV and its association with suicidal behaviors among adolescents is such an important issue for researchers, policymakers, and practitioners in the United States and around the world. Prevention and intervention efforts should be culturally tailored to reflect the unique experiences with physical TDV and suicide among minority populations such as sexual minority adolescents.
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Tessler RA, Langton L, Rivara FP, Vavilala MS, Rowhani-Rahbar A. Differences by Victim Race and Ethnicity in Race- and Ethnicity-Motivated Violent Bias Crimes: A National Study. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:6297-6318. [PMID: 30556489 PMCID: PMC6579725 DOI: 10.1177/0886260518818428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Over 80% of bias-motivated violent victimization is motivated by race or ethnicity and over 50% of bias victimization occurs in non-Hispanic Whites (NHW). Our aim was to determine the risk and health impacts of race/ethnicity-motivated violent victimization by victim race/ethnicity. We examined data from the National Crime Victimization Survey (2003-2015) to estimate violent victimization risk by victim race/ethnicity across race/ethnicity bias victimization, other types of bias victimizations, and non-bias violent victimizations. We examined incident and offender characteristics for race/ethnicity-motivated victimization by victim race/ethnicity. The risk of race/ethnicity-motivated violent victimization was greater for non-Hispanic Blacks (NHB) and Hispanics than for NHWs (incidence rate ratios [IRR] = 1.4; 95% confidence interval [CI] = [1.0, 2.0], and IRR = 1.6; 95% CI = [1.2, 2.1]). This translates into an additional 46.7 incidents per 100,000 person-years (95% CI = [1.4, 92.1]) for the NHB population and an additional 60.3 incidents per 100,000 person-years (95% CI = [20.3, 100.4]) for the Hispanic population. Violent incidents for NHB victims more frequently resulted in injury or medical care. Nearly 40% of NHB victims reported difficulties at school or work related to the incident where only 21.5% of NHWs and 11.7% of Hispanic victims reported similar problems. Roughly 37% of NHB victims identified a NHW offender and 45% of NHW victims identified a NHB offender. Hispanic victims identified NHB or NHW offenders in over 70% of incidents. Although literature suggests that NHWs account for the majority of bias victimizations, the risk of non-fatal violent victimization motivated by race/ethnicity is greater for NHBs and Hispanics. Crimes perpetrated against NHBs are likely more severe and victim/offender racial incongruity is common. Findings provide empiric evidence on race/ethnicity-related structural disadvantage with adverse health consequences.
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Affiliation(s)
- Robert A. Tessler
- Harborview Injury Prevention and Research Center
- Department of Surgery, UCSF East Bay
| | - Lynn Langton
- Department of Justice, Bureau of Justice Statistics, United States
| | - Frederick P. Rivara
- Harborview Injury Prevention and Research Center
- Department of Pediatrics, University of Washington
| | - Monica S. Vavilala
- Harborview Injury Prevention and Research Center
- Department of Anesthesiology and Pain Medicine, University of Washington
| | - Ali Rowhani-Rahbar
- Harborview Injury Prevention and Research Center
- Department of Epidemiology, University of Washington School of Public Health
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Gyamerah AO, Baguso G, Santiago-Rodriguez E, Sa'id A, Arayasirikul S, Lin J, Turner CM, Taylor KD, McFarland W, Wilson EC, Wesson P. Experiences and factors associated with transphobic hate crimes among transgender women in the San Francisco Bay Area: comparisons across race. BMC Public Health 2021; 21:1053. [PMID: 34078334 PMCID: PMC8173924 DOI: 10.1186/s12889-021-11107-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Trans women experience high rates of gender-based violence (GBV)-a risk factor for adverse health outcomes. Transphobic hate crimes are one such form of GBV that affect trans women. However, little is understood about factors that shape transphobic hate crimes and racial/ethnic variation in these experiences. To contextualize GBV risk and police reporting, we examined self-reported types and correlates of transphobic hate crimes by racial/ethnic group of trans women in the San Francisco Bay Area. METHODS From 2016 to 2018, trans women participated in a longitudinal cohort study of HIV. Secondary data analyses (N = 629) examined self-reported experiences of transphobic hate crimes (i.e., robbery, physical assault, sexual assault, and battery with weapon) by race/ethnicity, and whether hate crimes were reported to the police. Chi-square tests and simple logistic regression examined demographic, sociocultural, and gender identity factors associated with transphobic violence experiences and police reporting. RESULTS About half (45.8%) of participants reported ever experiencing a transphobic hate crime; only 51.1% of these were reported to the police. Among those who reported a hate crime experience, Black (47.9%) and Latina (49.0%) trans women reported a higher prevalence of battery with a weapon; White (26.7%) and trans women of "other" race/ethnicities (25.0%) reported a higher prevalence of sexual assault (p = 0.001). Having one's gender questioned, history of sex work, homelessness as a child and adult, and a history incarceration were associated with higher odds of experiencing a transphobic hate crime. Trans women who felt their gender identity questioned had lower odds of reporting a hate crime to the police compared to those did not feel questioned. CONCLUSIONS A high proportion of trans women experienced a transphobic hate crime, with significant socio-structural risk factors and racial differences by crime type. However, crimes were underreported to the police. Interventions that address structural factors, especially among trans women of color, can yield violence prevention benefits.
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Affiliation(s)
- Akua O Gyamerah
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, USA.
- Department of Community Health Systems, School of Nursing, University of California, 2 Koret Way, San Francisco, CA, 94143, USA.
| | - Glenda Baguso
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, USA
| | - Edda Santiago-Rodriguez
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, California, USA
| | - Aria Sa'id
- Transgender District, San Francisco, USA
| | - Sean Arayasirikul
- San Francisco Department of Public Health, Trans Research Unit for Equity, San Francisco, USA
| | - Jess Lin
- Department of Public Health, Center for Public Health Research, San Francisco, USA
| | - Caitlin M Turner
- San Francisco Department of Public Health, Trans Research Unit for Equity, San Francisco, USA
| | - Kelly D Taylor
- Institute for Global Health Sciences, University of California, San Francisco, USA
| | - Willi McFarland
- Department of Public Health, Center for Public Health Research, San Francisco, USA
| | - Erin C Wilson
- Department of Public Health, Center for Public Health Research, San Francisco, USA
| | - Paul Wesson
- Department of Epidemiology & Biostatistics, University of California, San Francisco, USA
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Briley PM, Gerlach H, Jacobs MM. Relationships between stuttering, depression, and suicidal ideation in young adults: Accounting for gender differences. JOURNAL OF FLUENCY DISORDERS 2021; 67:105820. [PMID: 33316554 DOI: 10.1016/j.jfludis.2020.105820] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/06/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE The purpose of this study was to investigate the relationship between depressive symptoms and suicidal ideation and living with stuttering while accounting for time, sex, and health-related confounders. METHOD The data for this study come from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative survey study that has followed 13,564 respondents over the course of 14 years. Responses to the question "Do you have a problem with stuttering or stammering?" at two time points were used to establish stuttering and non-stuttering groups. Regression analysis, propensity score matching, and structural equation modeling were used. RESULTS Compared to their fluent counterparts, males and females reported significantly elevated symptoms of depression. Although symptoms of depression among males who stutter were stable over time, depressive symptoms among females who stutter increased with age. Compared to males who do not stutter, males who stutter were significantly more likely to report feelings of suicidal ideation. There were no differences in suicidal ideation between females who do and do not stutter. CONCLUSIONS Speech-language pathologists should be aware of the associations between stuttering and depressive symptoms, as well as the increased risk for suicidal ideation among males who stutter. Clinicians should be knowledgeable about symptoms of depression and suicidal ideation and be familiar with processes to refer as needed.
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Affiliation(s)
- Patrick M Briley
- Department of Communication Sciences & Disorders, East Carolina University, Greenville, NC, USA.
| | - Hope Gerlach
- Department of Speech, Language, and Hearing Sciences, Western Michigan University, Kalamazoo, MI, USA
| | - Molly M Jacobs
- Department of Health Services & Information Management, East Carolina University, Greenville, NC, USA
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Wardecker BM, Graham-Engeland JE, Almeida DM. Perceived discrimination predicts elevated biological markers of inflammation among sexual minority adults. J Behav Med 2021; 44:53-65. [PMID: 32930919 PMCID: PMC7855007 DOI: 10.1007/s10865-020-00180-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 09/05/2020] [Indexed: 01/24/2023]
Abstract
Sexual minority (SM) adults (those who are lesbian, gay, or bisexual) consistently report more health problems compared to heterosexuals, and they tend to experience excess social stress. Although numerous studies have established links between social stress and clinical outcomes in SM adults, few studies have examined biological factors that may help explain how social stress leads to health disparities among SM adults. We used data from the Midlife in the United States Study (MIDUS) to examine whether two inflammatory markers that have been commonly associated with social stress-C-reactive protein (CRP) and interleukin-6 (IL-6)-differed by sexual orientation and whether any differences were explained by perceptions of discrimination. Participants self-identified as heterosexual (n = 1956) or lesbian, gay, or bisexual (n = 81). After controlling for age, gender, race, and education, SM individuals had higher CRP and IL-6 than heterosexuals on average and these differences were partially explained by perceptions of discrimination. Implications for inflammatory pathways as mechanisms related to SM health disparities and discrimination are discussed.
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Affiliation(s)
- Britney M Wardecker
- College of Nursing, The Pennsylvania State University, University Park, PA, USA.
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA.
| | - Jennifer E Graham-Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
| | - David M Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
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Williams AJ, Jones C, Arcelus J, Townsend E, Lazaridou A, Michail M. A systematic review and meta-analysis of victimisation and mental health prevalence among LGBTQ+ young people with experiences of self-harm and suicide. PLoS One 2021; 16:e0245268. [PMID: 33481862 PMCID: PMC7822285 DOI: 10.1371/journal.pone.0245268] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND LGBTQ+ youth have higher rates of self-harm and suicide than cisgender, heterosexual peers. Less is known about prevalence of risks within these populations. OBJECTIVES The first systematic review and meta-analysis to investigate the prevalence of risks among young people throughout the LGBTQ+ umbrella with experiences across the dimension of self-harm, suicidal ideation and suicide behaviour; and how they may differ between LGBTQ+ umbrella groups. DATA SOURCES MEDLINE, Scopus, EMBASE, PsycINFO, and Web of Science searches were run to identify quantitative research papers (database inception to 31st January, 2020). STUDY ELIGIBILITY CRITERIA Articles included were empirical quantitative studies, which examined risks associated with self-harm, suicidal ideation or suicidal behaviour in LGBTQ+ young people (12-25 years). SYNTHESIS METHODS 2457 articles were identified for screening which was completed by two independent reviewers. 104 studies met inclusion criteria of which 40 had data which could be meta-analysed in a meaningful way. This analysis represents victimisation and mental health difficulties as risks among LGBTQ+ youth with self-harm and suicide experiences. Random-effects modelling was used for the main analyses with planned subgroup analyses. RESULTS Victimisation and mental health were key risk factors across the dimension self-harm and suicide identified through all analyses. A pooled prevalence of 0.36 was indicated for victimisation and 0.39 for mental health difficulties within LGBTQ+ young people with experiences of self-harm or suicide. Odds ratios were calculated which demonstrated particularly high levels of victimisation (3.74) and mental health difficulties (2.67) when compared to cisgender, heterosexual counterparts who also had these experiences. CONCLUSIONS Victimisation and mental health difficulties are highly prevalent among LGBTQ+ youth with experiences of self-harm and suicide. Due to inconsistency of reporting, further risk synthesis is limited. Given the global inclusion of studies, these results can be considered across countries and inform policy and suicide prevention initiatives. PROSPERO REGISTRATION NUMBER CRD42019130037.
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Affiliation(s)
- A. Jess Williams
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
- School of Psychology, Self-Harm Research Group, University of Nottingham, Nottingham, United Kingdom
| | - Christopher Jones
- School of Psychology, Centre for Applied Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Jon Arcelus
- School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Ellen Townsend
- School of Psychology, Self-Harm Research Group, University of Nottingham, Nottingham, United Kingdom
| | - Aikaterini Lazaridou
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Maria Michail
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
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Eisenberg ME, Wood BA, Erickson DJ, Gower AL, Schneider SK, Corliss HL. Associations between LGBTQ+-supportive school and community resources and suicide attempts among adolescents in Massachusetts. AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2021; 91:800-811. [PMID: 34516147 PMCID: PMC9972362 DOI: 10.1037/ort0000574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Supportive school and community resources are associated with reduced risk of suicidality among lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ +) adolescents as well as their cisgender, heterosexual peers. This study examined whether adolescents attending schools and living in communities with more versus fewer LGBTQ +-supportive resources were at lower risk of a past-year suicide attempt. Data on sexual orientation and past-year suicide attempt were obtained from student surveys administered in 30 Massachusetts public high schools between 2014 and 2017 (N = 20,790). Data on school resources were obtained from a questionnaire administered to school officials, and community resources were assessed through internet searching. Modified Poisson generalized estimating equations tested associations between school and community LGBTQ +-supports and suicide attempt separately by sex/gender, adjusting for student, school, and community covariates. Several school resources and the availability of community-wide LGBTQ +-supportive resources were associated with lower risk of a suicide attempt among several subgroups of students, even after controlling for the presence of multiple school and community resources and covariates. For example, the risk of a suicide attempt among gay, bisexual and questioning boys in schools with a gender-neutral restroom was approximately half compared to gay, bisexual and questioning boys in schools without this resource. Past year suicide attempts were also significantly lower among questioning, RR = 0.56, CI [0.37-0.86], and heterosexual, RR = 0.59, CI [0.50-0.68], girls living in communities with more supportive resources compared to those in communities with fewer resources. LGBTQ +-supportive resources in schools and communities may be beneficial for all adolescents regardless of sexual orientation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota
| | - Brittany A. Wood
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego
| | - Darin J. Erickson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Amy L. Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota
| | | | - Heather L. Corliss
- San Diego State University, School of Public Health,Institute for Behavioral and Community Health, San Diego State University
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Rabasco A, Andover M. The Influence of State Policies on the Relationship Between Minority Stressors and Suicide Attempts Among Transgender and Gender-Diverse Adults. LGBT Health 2020; 7:457-460. [PMID: 33090075 DOI: 10.1089/lgbt.2020.0114] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: We examined whether the relationship between minority stressors (victimization and discrimination) and suicide attempts (SAs) was moderated by gender identity-specific protective state policies in a sample of transgender and gender-diverse (TGD) adults. Methods: TGD adults (n = 133) were recruited online and completed questionnaires. Results: Protective state policies moderated the relationship between minority stressors and SAs, with a significant positive association between minority stressors and SAs at low, but not medium and high, policy scores. Conclusion: A lack of protective state policies may be a risk factor in the relationship between minority stressors and SAs among TGD individuals.
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Affiliation(s)
- Ana Rabasco
- Psychology Department, Fordham University, New York, New York, USA
| | - Margaret Andover
- Psychology Department, Fordham University, New York, New York, USA
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The link between LGBTQ-supportive communities, progressive political climate, and suicidality among sexual minority adolescents in Canada. Prev Med 2020; 139:106191. [PMID: 32653353 PMCID: PMC8474062 DOI: 10.1016/j.ypmed.2020.106191] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 01/09/2023]
Abstract
Despite supportive structural changes to reduce stigma towards lesbian, gay, and bisexual, transgender, queer, and questioning (LGBTQ) Canadian residents, sexual minority youth still face disparities compared to heterosexual peers. We aimed to characterize LGBTQ-supportive environments and political climates, and examine their links to suicidal behavior among sexual minority adolescents in western Canada. Data were from the 2013 British Columbia Adolescent Health Survey, a cluster-stratified random cross-sectional survey of public school students in BC, Canada; We sampled 2678 self-identified LGB and mostly heterosexual students (69% girls) from 274 schools, representing an estimated provincial population of 24,624 sexual minority students in weighted models. Student reports of past-year suicidal ideation, suicidal attempts, and self-harm behaviors were merged with community-level data assessing diverse aspects of LGBTQ-supportive resources and progressive political climates in communities surrounding the schools. Adjusted multilevel models showed that for sexual minority adolescent girls, higher community LGBTQ-supportiveness predicted marginally significant lower suicidal ideation (aOR = 0.94, 95% CI [0.88, 1.01]) and suicidal attempts (aOR = 0.91, 95% CI [0.83, 1.00]) and significantly lower self-harm behaviors (aOR = 0.91, 95% CI [0.85, 0.98]). Further, progressive political climates predicted marginally significant lower suicidal ideation (aOR = 0.89, 95% CI [0.78, 1.02]) and significantly lower self-harm behaviors (aOR = 0.87, 95% CI [0.77, 0.99]). For sexual minority adolescent boys, no community-level variables were associated with suicidal behavior in adjusted models. Thus, LGBTQ-supportive communities and progressive political climates appear to be protective against suicidal behavior among sexual minority adolescent girls, but not sexual minority adolescent boys.
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Hswen Y, Qin Q, Williams DR, Viswanath K, Brownstein JS, Subramanian SV. The relationship between Jim Crow laws and social capital from 1997-2014: A 3-level multilevel hierarchical analysis across time, county and state. Soc Sci Med 2020; 262:113142. [PMID: 32893046 DOI: 10.1016/j.socscimed.2020.113142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/19/2020] [Accepted: 06/08/2020] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Jim Crow laws in the United States promoted racial prejudice, which may have reduced social capital. Our study tests the relationship between Jim Crow laws and social capital. METHODS We conducted 3-level multilevel hierarchical modeling to study differences in the stock of social capital for 1997, 2005, 2009 in Jim Crow states compared to states without Jim Crow laws. We examined the moderation effects of county level median income, percent Black and percent with high school education and Jim Crow laws on social capital. RESULTS Jim Crow laws significantly reduced stock of social capital across 1997, 2005, 2009. The model was robust to the inclusion of random county, states, time and fixed county and state level covariates for median income, percent Black and percent with high school education. The largest percent of between state variations explained for fixed variables was from the addition of Jim Crow laws with 2.86%. These results demonstrate that although Jim Crow laws were abolished in 1965, the effects of racial segregation appear to persist through lower social connectiveness, community and trust. A positive moderation effect was seen for median income and percent Black with Jim Crow laws on social capital. DISCUSSION Our study supports a negative association between Jim Crow laws and reduction in the stock of social capital. This may be attributed to the fracturing of trust, reciprocity and collective action produced by legal racial segregation. Findings from this study offer insight on the potential impacts of historical policies on the social structure of a community. Future research is necessary to further identify the mechanistic pathways and develop interventions to improve social capital.
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Affiliation(s)
- Yulin Hswen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Computational Epidemiology Lab, Harvard Medical School, Boston, MA, USA; Innovation Program, Boston Children's Hospital, Boston, MA, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
| | - Qiuyuan Qin
- Department of Mathematics and Statistics, Boston University, Boston, MA, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Graduate School of Arts and Sciences, Harvard University, Cambridge, MA, USA
| | - K Viswanath
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Graduate School of Arts and Sciences, Harvard University, Cambridge, MA, USA; Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| | - John S Brownstein
- Computational Epidemiology Lab, Harvard Medical School, Boston, MA, USA; Innovation Program, Boston Children's Hospital, Boston, MA, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Graduate School of Arts and Sciences, Harvard University, Cambridge, MA, USA
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Baiden P, LaBrenz CA, Asiedua-Baiden G, Muehlenkamp JJ. Examining the intersection of race/ethnicity and sexual orientation on suicidal ideation and suicide attempt among adolescents: Findings from the 2017 Youth Risk Behavior Survey. J Psychiatr Res 2020; 125:13-20. [PMID: 32179279 DOI: 10.1016/j.jpsychires.2020.02.029] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/02/2020] [Accepted: 02/26/2020] [Indexed: 12/28/2022]
Abstract
Although some studies have examined factors associated with suicidal behaviors, few studies have examined the intersection of sexual orientation and race/ethnicity on suicidal behaviors among adolescents. The objective of this study is to examine the intersection of sexual orientation and race/ethnicity on suicidal ideation and suicide attempt. We hypothesized that controlling for the effects of known risk factors for suicidal behaviors, there will be an interaction effect between sexual orientation and race/ethnicity on suicidal behaviors. Data for this study came from the 2017 Youth Risk Behavior Surveillance System. A sample of 13,697 adolescents aged 14-18 years (51.8% female) was analyzed using binary logistic regression. Of the 13,697 adolescents, 17.7% reported suicidal ideation and 7.7% made at least one suicide attempt during the past 12 months. In the multivariate logistic regression models, non-White sexual minority adolescents are less likely to report suicidal ideation. However, Hispanic lesbian/gay adolescents had 1.71 times higher odds of making a suicide attempt. Odds of suicide attempt are 1.2 times higher for Black or African American bisexual adolescents and American Indian/Native Hawaiian/Pacific Islander bisexual adolescents had 2.44 times higher odds of making a suicide attempt. Other significant predictors of suicidal behaviors include a history of sexual assault, a victim of bullying, depression, cigarette smoking, misuse of prescription pain medication, and illicit drug use. The findings of the present study extend past research on the intersection of sexual orientation and race/ethnicity on mental health problems among adolescents including suicidal behaviors.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, USA.
| | - Catherine A LaBrenz
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, USA
| | | | - Jennifer J Muehlenkamp
- University of Wisconsin-Eau Claire, Department of Psychology, 105 Garfield Avenue, Eau Claire, WI, 54702, USA
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Paceley MS, Fish JN, Thomas MMC, Goffnett J. The Impact of Community Size, Community Climate, and Victimization on the Physical and Mental Health of SGM Youth. JOURNAL OF YOUTH STUDIES 2020; 52:427-448. [PMID: 34413699 PMCID: PMC8372682 DOI: 10.1177/0044118x19856141] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sexual and gender minority (SGM) youth experience high rates of victimization leading to health disparities. Community size and community climate are associated with health outcomes among SGM youth; however, we lack studies that include them as covariates alongside victimization to understand their collective impact on health. This study utilized minority stress theory to understand how community context shapes experiences of victimization and health among SGM youth. SGM youth in one Midwestern U.S. state completed an online survey (n = 201) with measures of physical health, mental health, community context, and victimization. Data were analyzed via multiple regression using a path analysis framework. Results indicate that perceived climate was associated with mental, but not physical, health; Community size was unrelated to health outcomes. Victimization mediated the association between community climate and mental health.
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Wirtz AL, Poteat TC, Malik M, Glass N. Gender-Based Violence Against Transgender People in the United States: A Call for Research and Programming. TRAUMA, VIOLENCE & ABUSE 2020; 21:227-241. [PMID: 29439615 DOI: 10.1177/1524838018757749] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Gender-based violence (GBV) is an umbrella term for any harm that is perpetrated against a person's will and that results from power inequalities based on gender roles. Most global estimates of GBV implicitly refer only to the experiences of cisgender, heterosexually identified women, which often comes at the exclusion of transgender and gender nonconforming (trans) populations. Those who perpetrate violence against trans populations often target gender nonconformity, gender expression or identity, and perceived sexual orientation and thus these forms of violence should be considered within broader discussions of GBV. Nascent epidemiologic research suggests a high burden of GBV among trans populations, with an estimated prevalence that ranges from 7% to 89% among trans populations and subpopulations. Further, 165 trans persons have been reported murdered in the United States between 2008 and 2016. GBV is associated with multiple poor health outcomes and has been broadly posited as a component of syndemics, a term used to describe an interaction of diseases with underlying social forces, concomitant with limited prevention and response programs. The interaction of social stigma, inadequate laws, and punitive policies as well as a lack of effective GBV programs limits access to and use of GBV prevention and response programs among trans populations. This commentary summarizes the current body of research on GBV among trans populations and highlights areas for future research, intervention, and policy.
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Affiliation(s)
- Andrea L Wirtz
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Tonia C Poteat
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Mannat Malik
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Department of Health Behavior and Society, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Nancy Glass
- Department of Community-Public Health, Johns Hopkins School of Nursing, Baltimore, MD, USA
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Zervoulis K, Smith DS, Reed R, Dinos S. Use of ‘gay dating apps’ and its relationship with individual well-being and sense of community in men who have sex with men. PSYCHOLOGY & SEXUALITY 2019. [DOI: 10.1080/19419899.2019.1684354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | - David S. Smith
- School of Applied Social Studies, Robert Gordon University, Aberdeen, UK
| | - Rhiannon Reed
- Department of Psychology, BPP University, London, UK
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Phillips G, Beach LB, Turner B, Feinstein BA, Marro R, Philbin MM, Salamanca P, Felt D, Birkett M. Sexual Identity and Behavior Among U.S. High School Students, 2005-2015. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1463-1479. [PMID: 31123950 PMCID: PMC6597280 DOI: 10.1007/s10508-019-1404-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 05/26/2023]
Abstract
Sexual orientation is a multidimensional construct which is increasingly recognized as an important demographic characteristic in population health research. For this study, weighted Youth Risk Behavior Survey data were pooled across 47 jurisdictions biennially from 2005 to 2015, resulting in a national sample of 98 jurisdiction-years (344,815 students). Respondents were a median of 15.5 years, 49.9% male, and 48.8% White. Sexual identity and behavior trends from 2005 to 2015 were assessed with logistic regression analysis. Overall, 13.9% of females and 7.0% of males identified as lesbian, gay, bisexual (LGB), or not sure, while 9.1% of females and 4.2% of males indicated both same-and-different-sex behavior or same-sex behavior. In total, 17.0% of female and 8.5% of male youth reported non-heterosexual (LGB or not sure) sexual identity, same-sex sexual behavior, or both. LGB youth were approximately twice as likely as other youth to report lifetime sexual behavior. White and Asian youth were less likely to report non-heterosexual identity and/or have engaged in same-sex sexual behaviors than youth of other races/ethnicities. Prevalence of non-heterosexual identities increased over time for both sexes, but only female youth reported significantly more same-sex behavior over time. This is the first study to simultaneously assess adolescent sexual identity and behavior over time within a national dataset. These findings are critical for understanding the sexual health needs of adolescents and for informing sexual health policy and practice.
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Affiliation(s)
- Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA.
| | - Lauren B Beach
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA
| | - Blair Turner
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA
| | - Brian A Feinstein
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA
| | - Rachel Marro
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA
| | - Morgan M Philbin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Paul Salamanca
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA
| | - Dylan Felt
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA
| | - Michelle Birkett
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA
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Gamarel KE, Nelson KM, Heinze J, Chiaramonte DM, Miller RL. The moderating role of resilience resources in the association between crime exposure and substance use among young sexual minority men. Subst Use Misuse 2019; 54:1787-1798. [PMID: 31094618 PMCID: PMC6692916 DOI: 10.1080/10826084.2019.1610447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objectives: Substance use is prevalent among young sexual minority men and crime exposure is linked with adverse health behaviors. Guided by the protective model of resilience, we examined the impact of crime exposure and resilience resources on substance use behaviors, and whether resilience moderated associations between crime exposure and substance use behaviors. Methods: A cross-sectional sample of young sexual minority men (n = 720) ages 15-24 participated in a one-time survey conducted in seven cities across the United States. Participants' mean age was 21.2 years; 50% self-identified as Black, and 66% self-identified as gay. Participants self-reported on sociodemographic factors, crime exposure, resilience resources, and substance use behaviors. We fit generalized estimating models to examine associations between crime exposure, resilience resources, and the interaction between crime exposure and resilience resources on substance use behaviors. Results: Overall, 31% reported heavy alcohol use, 54% monthly marijuana use, 14% drug use, and 26% reported being a victim of a crime. Crime exposure was associated with an increased odds of alcohol (AOR = 1.45, 95%CI: 1.02, 2.14), marijuana (AOR = 1.41, 95%CI: 1.07, 2.04), and drug use (AOR = 1.94, 95%CI: 1.14, 2.98). Resilience resources were associated with a reduced odds of alcohol use (AOR = 0.66, 95%CI: 0.47, 0.93), marijuana use (AOR = 0.82, 95%CI: 0.60, 0.98), and drug use (AOR = 0.85, 95%CI: 0.54, 0.96). There was a significant interaction such that resilience resources reduced associations between crime exposure and alcohol and drug use. Conclusions: Findings support the protective effects of resilience resources for young sexual minority men. Results highlight the importance of ensuring the availability of community resources to meet the needs of sexual minority youth.
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Affiliation(s)
- Kristi E. Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health
| | - Kimberly M. Nelson
- Centers for Behavioral and Preventative Medicine, The Miriam Hospital
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Justin Heinze
- Department of Health Behavior and Health Education, University of Michigan School of Public Health
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Albuquerque MRTCD, Botelho NM, Rodrigues CCP. Atenção integral à saúde da população LGBT: Experiência de educação em saúde com agentes comunitários na atenção básica. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2019. [DOI: 10.5712/rbmfc14(41)1758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objetivo: Relatar uma experiência de educação em saúde com agentes comunitários de saúde acerca da saúde da população LGBT na atenção básica. Métodos: Foi realizada uma ação de educação continuada por meio do estudo de casos escolhidos pelos agentes de saúde dentro de suas microáreas de atuação seguida de discussão em grupo e reflexão sobre as práticas vigentes. Resultados: Foram discutidos três casos apresentados pelos agentes de saúde que abordavam as temáticas de: (1) a escola e o preconceito; (2) a importância do apoio familiar e social; e (3) o papel da estratégia saúde da família e da educação em saúde. Percebeu-se que o tema permanece excluído das grandes discussões, sobretudo nas escolas médicas e na atenção básica, que é o primeiro contato do usuário com o Sistema Único de Saúde. Dessa forma, estratégias que objetivem discutir as peculiaridades da prevenção, promoção e assistência à saúde desses grupos devem ser estimuladas e reproduzidas tendo em vista uma melhor qualidade do atendimento a fim de captar esses pacientes em um ambiente favorável a práticas integrativas com respeito à diversidade sexual. Conclusão: Conclui-se que a atividade educacional realizada foi de extrema importância para desmistificar mitos e preconceitos envolvendo a saúde LGBT no cenário da atenção básica. Observou-se que após a atividade educacional os ACS se mostraram mais confiantes e sensibilizados sobre as temáticas abordadas e mudaram concepções no sentido de respeitar as decisões dos pacientes e realizar abordagem adequada para o acolhimento a esses usuários.
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Suicidal behaviour among sexual-minority youth: a review of the role of acceptance and support. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 3:190-198. [DOI: 10.1016/s2352-4642(18)30400-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 11/20/2022]
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